When Public Policy Squeezes Out Providers

The aptly named Stanley Bleecker foresees a problem for Rhode Islanders needing health care in the future:

Can you imagine a time when sick people will not have access to a doctor when they are in need of treatment and medical advice? I can. Recently, because of my primary doctor’s retirement, I had to find an internist and also a specialist. It was not easy. After some effort, I did secure an appointment for an annual physical with a new internist, but the earliest appointment I could get was scheduled for 12 months down the road. Subsequently, I learned my new doctor (whom I still have not yet met) has closed his practice to new patients.

The shortage is a result of many Rhode Island doctors taking early retirement or leaving to practice in other states where insurance payments are higher. Practicing doctors tell me that young doctors are not interested in practicing in Rhode Island because of low insurance payments.

Mr. Bleecker might be somewhat encouraged to learn that Rhode Island has legalized the provision of telemedicine, whereby patients don’t have to be physically present in the office to receive care. Of course, this being Rhode Island, there’s a catch:

Rhode Island providers, however, may not use telemedicine to deliver health care services across state borders. This limitation is subject to change if Rhode Island lawmakers choose to enter the Interstate Medical Licensure Compact (“IMLC”).

In some respects, Rhode Island is moving in the wrong direction:

Similarly, Rhode Island nurses may not deliver health care services via telemedicine to patients across state borders. This was not always the case. For nearly a decade, Rhode Island was a member of the Nurse Licensure Compact (“NLC”), which permitted Rhode Island registered nurses and licensed/practical vocational nurses to use telemedicine to provide health care in 24 other states across the country.

Attentive readers might recall that Donna Cook pointed this out back in September, as a problem for professional nurses.

This shouldn’t be such a hard lesson. When government makes it more difficult to pursue a profession or creates artificial markets with near monopolies for insurers, people will stop finding it worthwhile to go into that line of work, here. Too often, those who craft our laws imagine that the targets of their impositions will not react.

Featured image: “Dentistry” illustration by True Williams from the original edition of Mark Twain’s novel, Tom Sawyer.